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[Kat P]

So I have been having issues for a while now relating to general health.

I am hypothyroid, I also have Raynaud's as smidge of arthritis.

So trying to be brief, my period STOPPED in August. 1st of the month was the last bleed and nothing since. Previous to that I was regular, but there was no new fresh blood as such.
I am able to use period underwear or even normal underwear to 'free bleed' as such, as there is literally no flow. This has been the case for 6 or 8 months at least.
I have had a coil in place for waaaaaay too long (past trauma) so from a hormonal point of view, that has done nothing for at least 3 years (no judgement).

Ok, so I went for a chat with the GP practice nurse about routine blood tests for thyroid and they did a full blood panel. Most things ok, lowered kidney function, low ferritin, thyroid is HYPER right now due to over medication as shown with 2x recently. Another being done in 5 weeks.
While I was there she reminded me my smear was due so we agreed to do that AND remove the coil, and discussed the use of mini pill as I can't use combined.
Since then I have had ZERO BLEED, and at that point I was 2 weeks late for my period.

I am having my weight monitored as BMI is underweight and the nurse thinks Hypothalmic amenorrhea based on the history of bleeding, or lack of combined with low body weight, my training schedule with weights all pointing to low energy availability. More detail here - I have trained for almost 8 years now, and nothing new has changed aside from calorie intake.


So she chatted with the GP who did some further tests for FSH, LH testosterone prolactin and some others, and those have all come back 'normal' for someone who has been using the mini pill.
BUT all my issues are pre dating when that pill was started.

I questioned if it was 'normal' for there to be no bleed after the coil removal, and should I be concerned about not having had a bleed since Aug 1st naturally, and I just now keep getting told it's the pill.
They seem to be questioning why I am worried about not bleeding while most women would be happy, and I keep telling them because I feel like they arent seeing the bigger picture, and that something doesn't feel right.

Mental health wise, I having been feeling incredibly low for months. Depression, anxiety poor self esteem and other awful thoughts, which has in turn triggerd a past ED, which I will be say I was not 100% honest about with the GP but I did tell her I wasn't able to eat well with how I had been feeling.
With my thyroid condition, it throws up so many curve balls, I  never know what is 'normal'.
The relationship with my husband has been strained.
Zero libido, we had sex once since 1st August and its always been a weekly thing even after 24 years together.

I could go on, but I get the feeling I am in the same boat as many people with a list as long as my arm with what I feel is wrong

My gp thanfully has consulted with a gyno on my situation, and has suggested starting everol sequi or astradiol gel 0.06% , alongside 200mg progesterone.
I am of course now seeing advice on if this is the best course of action. My mum basically said it could be a miracle for me as it changed her life when she started HRT.

However I am 42, and I don't know if this is too early, and if this is not needed, why would they offer it?

Sorry if I am asking things that have been asked before.

[CLKD]

Morning.  We cannot go into peri menopause 'too early', medics seem to be fixed on the age of 52 .........

Peri-menopause: those years  B4 the final bleed when we may notice odd symptoms: anxiety levels may rise, low mood, the need to change what we eat ........



It may be that your periods stopped.  End of.  Mine waxed and waned for a few years B4 disappearing.  U may find that in a few months U will get more  .  Then a break. 

What is the reason for removing the Mirena?  It's delivering progesterone to protect the womb? 

I a fellow ED suffered here, from age 3  ........... whilst much better in recent years, any1 shouting can set it off as can being 'constipated' .  Awful.  Is the reason why you exercise regularly? and nothing new has changed aside from calorie intake..  I never counted calories ............ fear stops me eating.

Some find that keeping a mood/food/symptom diary of use to chart progress.  As thyroid is a hormone it is often upset during peri!  Browse round, make notes ;-)

[Wrensong]

Hello Kat P, welcome to the forum & I'm sorry you're in this situation.

I can't get involved in a potentially long thread just now, but as a hypothyroid woman on thyroid replacement for 30+ years I know how complicated this condition can make life & I feel for you.  So, just quickly, I think you need to address the situation you describe in the following 3 extracts from your post:-

thyroid is HYPER right now due to over medication

I am having my weight monitored as BMI is underweight and the nurse thinks Hypothalmic amenorrhea based on the history of bleeding, or lack of combined with low body weight, my training schedule with weights all pointing to low energy availability. More detail here - I have trained for almost 8 years now, and nothing new has changed aside from calorie intake.

a past ED, which I will be say I was not 100% honest about with the GP but I did tell her I wasn't able to eat well with how I had been feeling.

I'm a bit confused about the timing of your starting the pill, what type it is (whether expected to be bleed free or not), the "old" Mirena I think was assumed to be ineffective for some time prior to its removal - and whether these may account for the very scant/absence of bleeds, if the Mirena might have been exerting some effect for longer than you thought

there is literally no flow. This has been the case for 6 or 8 months at least.

& your comment

BUT all my issues are pre dating when that pill was started.

Apologies if I've not understood well. 

All that aside, to go back to what I said at the start of this post, if your thyroid has been over-treated for some time, you are underweight, perhaps training too hard & taking in too few calories, all of these could also cause your periods to stop and have adverse effects on your long term health in other ways. 

I think you need to work closely with your medical team to get your BMI into the healthy range.  Correct your thyroid status (I'm assuming your dose has been reduced to bring this about), make sure you are getting enough calories with a healthily balanced diet & get advice on what you should do about exercise if your training regime has been excessive/unsuitable.  Hopefully, together, these measures will help you avoid a premature menopause.

Good luck with it all.
W x

[bombsh3ll]

You are 42 with normal FSH and last had sex in August and a period at the start of that month.

Have you done a pregnancy test?

Also you say you can't take the combined pill - what is the reason for that? Often women are told (or simply believe) they can't take the pill for spurious reasons.

Nonetheless if you have oligomenorrhea anyway it may not improve your quality of life as much as it does for most perimenopausal women.

There is certainly mileage in trialling hormone therapy - I would push for a therapeutic dose of estradiol, testosterone and a progestogen that meets your needs in terms of bleeding vs you meeting its needs.

[Kathleen]

Hello Kat P and welcome to the forum.

You say that your blood tests are normal but I have recently learned that a Ferritin level of below 30.ug/L is indicative of iron deficiency despite this being in the normal range.
Iron deficiency can cause many issues including loss of appetite.

I wonder if your tests included C Reactive Protein ( CRP) which is a marker for inflammation. Your numbers may be high due to your arthritis and this can artificially raise Ferritin levels making them look healthier than they truly are.

Perhaps research the signs and symptoms of iron deficiency and see if any of them apply to you.

I hope this helps in some way and I wish you well.

K.

[Kat P]

Hi, all sorry I didn't know I had received any responses.

Not pregnant as we have always used condoms, NEVER had sex without one. And I have had to do many tests while the nurse and GP were doing their investigations.

The coil has been out of date for an embarrassing 4 years.

My thyroid has been underactive for the most. I was over medicated during covid and again recently, but possibly only for 6 months or so.

My GP is not making any effort to see why my weight is low, or making suggestions, BUT I have rasied cals and gained 3lb already mostly a bit of water, but it's an extra 500 cals daily right now, all carbs, so some water fluctuations are expected.

Regarding not having the combines pill is parents history of blood clots. So I am suprised that ive been given these patches?

Also the coil was not replaced as the nurse removed it during a smear knowing full well it needed to come out and I had been putting it off for a long time. She is not able to replace only remove.

Sorry if I have missed anything, i'll try and get back and be more in depth with answers, but I just know it's a bit of a stupid situation, and I just feel like i'm making something of nothing.

[bombsh3ll]

I think if you are not menstruating regularly at 42, whether due to hypothalamic amenorrhea or early menopause, a combination of the two, or another undiagnosed condition, you would be smart to be on some form of estrogen replacement.

Parental history of DVT is not necessarily a contraindication to the combined pill - my dad had a provoked DVT age 67, his thrombophilia screen was negative and I have zero fear of taking the pill.

However if you feel uncomfortable about this, and also the main benefit of the pill is that when taken continuously it gets rid of periods, which isn't your issue here anyway, then you can use estradiol hormone therapy patches.

These have no increased risk of thrombosis.

You will need to take some form in progestogen to protect your endometrium - another IUS is an option, however if you don't want or cannot access this, there are plenty of oral options - speak to your GP.

Additionally if you are not bleeding to begin with, you can choose between having monthly withdrawal bleeds or a bleed free regimen.

[common-lime]

*waves* another person with a history of HA here. I've ranged from life threateningly underweight in my mid-20s to borderline healthy (and with regularish periods) at this point in my life. My mum didn't start peri until her late 40s, whereas I started noticing the first symptoms ten years sooner, getting intense enough for me to ask about HRT when I was 40. My gynae floated the idea that my weight and activity level might be contributing as you become less resilient to these things as you age, but said he recommended HRT regardless of the cause to protect against further bone density loss. So far it's gone really well. I have migraines with aura and a family history of stroke/thrombosis, but transdermal estrogen like patches and gel doesn't carry the same risks as oral. Good luck 

[CLKD]

  common-lime